Correlation Between Graft Pulsatility Index During Coronary Artery Bypass Grafting And Early Postoperative Myocardial Infarction

ObjectiveTo investigate the correlation between pulsesatility index(PI)of transit time flow measurement(TTFM)in coronary artery bypass grafting(CABG)and early postoperative myocardial infarction,and to further explore the predictive value of intraoperative pulsesatility index for early postoperative prognosis.MethodsThe perioperative data of 75 patients with CABG in the department of cardiac surgery of Henan Provincial People’s Hospital from July to December 2017 were retrospectively analyzed.Transit time flow measurement was measured in all patients before the end of surgery,and indexes such as PI,mean graft flow(MGF)and diastolic flow(DF)were recorded.And we recorded postoperative electrocardiogram(ECG),cardiac troponin I(cTnI),creatine kinase isoenzyme MB(CK-MB),etc.The t test was used to compare the intraoperative PI between the myocardial infarction group and the non-myocardial infarction group.The correlation between PI and early postoperative myocardial infarction was analyzed by linear regression.ResultsAccording to the inclusion criteria and exclusion criteria,a total of 75 cases were included,49 males(65.3%),63.67±7.63 years old,26 cases(34.7%)with diabetes,46 cases(61.3%)with hypertension,and body mass index(BMI)of 25.14 ± 2.89kg/m2.Preoperative Heart function classification(New York Heart Association,NYHA classification)was 2.83 ± 0.53,preoperative cardiac troponin I(cTnI)was 58.48 ±156.81 ng/L,Ultrasound Cardiogram(UCG)tip:left ventricular ejection fraction(LVEF)was 57.72±7.02%.PI of left internal mammary artery(LIMA)was 2.22 ±0.85,MGF was 29.81±19.74ml/min,DF was 72.92±7.13%,PI of SVG trunk was 2.04±0.78,MGF was 58.24±30.46ml/min,DF was 69.32±7.14%,PI of all transplanted grafts was 2.11±0.90,MGF was 39.02±26.95ml/min,DF was 70.13 ±8.37%.PI of trunk SVG(1.91 ± 0.51 vs 2.16 ± 0.98,P=0.031<0.05)and DF of all grafts(75.90±3.63 vs 67.68±6.86,P=0.010<0.05)in the myocardial infarction group and the non-myocardial infarction group was statistically significant.PI of trunk SVG was correlated with 48CK-MB after surgery(P=0.038<0.05),and it was Strong correlation(correlation coefficient,r=0.408>0.4).For LIMA,when PILIMA was3,PI was correlated with postoperative cTnI peak(P=0.035<0.05)and was significantly correlated(r=0.567>0.4).For Left Circumflex(LCX)to saphenous vein graft(SVG LCX),when PISVG Lcx was≥2.5,there was a significant correlation between PISVG LCX and postoperative cTnI peak(P=0.011<0.05)and a high linear correlation(r=0.911>0.8).ConclusionIntraoperative PI was correlated with early postoperative myocardial infarction.There is a linear relationship between cTnI level and PI level of transplanted grafts,and when PILIMA≥3 and PISVG LCX≥2.5,cTnI level shows a significant increase.PI has a certain value in predicting early myocardial infarction after coronary artery bypass grafting.